Wednesday, December 17, 2014

All Better Now

Yesterday afternoon, I went to the lab and acted like a human pincushion to see where I stand with anemia and - thank you modern medicine and the internet - I already received results by the time I got up this morning.  Which was 3 am.  Seriously, my lab rocks!  I won't keep you in suspense - my iron and hemoglobin levels are both back up to normal!!  Hooray!

Fe = Iron, in case you slept through high school Chemistry like I did.  TIBC means Total Iron Binding Capacity.  I assume these levels were over the normal range in August because there was no iron to bind to, but that's a guess.  Transferrin Saturation  tells you the percentage of how much iron is actually being bound.
Hematocrit measures how much of your blood is red blood cells, and hemoglobin is the protein in your RBCs that carries oxygen.  (And by the way, thank you Wikipedia!)
If you're just finding my blog because you've Googled some incarnation of the phrase "iron loss from overtraining" or "running with anemia," welcome!  I hope you stick around and enjoy what you read.  My last post about being anemic has garnered more views than almost any other post I've written in the nearly five years I've been blogging, so I wanted to make sure I put out a follow-up so readers will know that there is hope for athletes getting over anemia!  

If you're looking for scientific explanations of anemia and how it affects running, I highly recommend that you go see Jaymee Marty, who is an Olympic Trials qualifier at the marathon distance and an actual scientist who has been dealing with blood loss and anemia issues much of this year.  She'll crunch the numbers and explain the data.  I'm just going to tell you how being anemic feels.

It feels like crap.

Oh, you wanted more than that?  Okay, here's more.

Many moons ago, in early spring of this year, I was doing a whole lot of running.  Like 50-ish mile weeks, which is a lot for me.  I tend to hover in the 30-40 mile range.  I had just come off of a pretty hardcore marathon training cycle and was - with very little recovery - gearing up for a trio of ultras.  Yeah, I knew it was going to be tough on my body, but I felt like I was taking it smart.  I wasn't ramping up to anything crazy mileage-wise, I was following the 10% rule of building, and every third or fourth week was a cutback/recovery week.  I felt good.  I felt strong.  I ran a kickass 50K in February.  Then I ran a kickass 50-miler in April.  I felt tired after the 50-miler, and maybe I pushed a little too much to keep up with my training schedule, but I had a 100K on the books for early May.  That turned into a mediocre 50K, which wasn't the day I had hoped for but wasn't exactly something to sneeze at, effort-wise.  That was followed by a fast-for-me half marathon the very next week.  And then a fast-ish 5K a few weeks after that.  And then another half marathon a few weeks after that.  Okay, when I write it all down like that, it looks like maybe I was an idiot.

But I felt at the time like I was being good!  I had cut way, way back on mileage in May and June.  It seemed like enough recovery, and you know what?  If I had stayed at that way back mileage for just a little bit longer, I think I would have been fine.  I think my real problem was July, when I swept right back into high volume training.

Exhibit A - my Strava training calendar.
July was hard.  I knew I was pushing myself, but I was stubborn about it, as we runners on the verge of injury can be.  I was tired and crabby.  I was working long hours.  I wasn't enjoying much of anything, particularly running.  Everything felt difficult, and I - who never, ever naps - was finding myself on the couch a lot.

I cut back my mileage again, but even then I was struggling.  It was hard to breathe and my body felt uncoordinated.  Everything sucked, I felt like I was losing my mind, and even my work was suffering, so it was time to call the doctor.  I felt pretty certain I had low iron, but it was such a relief to have it confirmed!  I was not, in fact, crazy (about this - no guarantees on anything else that floats around in my head).

Here's the part of the post where I'm going to sound like the voice of doom if you are currently struggling with low iron:  there's nothing you can do that speeds up the process of re-gaining iron.  It's a "cut way the fuck back on training, eat right, get a lot of sleep, take your iron supplements, and sit on your ass" waiting game.


But that's all you can do.

I am a pretty good eater.  Well, I mean, I eat like a champion, but nutritionally speaking, I do okay.  More or less plant-based.  Not a ton of processed foods.  Easy on the sugar.  Spinach is a daily thing, but red meat is not.  I tried to eat red meat a couple of times, because the internet told me it's good for iron, but... ick.  So, I didn't do myself a lot of favors in the eating animal iron department, but I made sure to include as many other iron-rich foods as I could, as well as foods with Vitamin C, which helps your body absorb iron.  And I took (still take) a daily iron supplement.

I made sleep a priority.  I actually sleep like a champion, too, and rarely pass up an opportunity to go to bed early, so this wasn't hard.  But I cleared a lot of my schedule during the day for naps, too.  There were times when I simply could not move off of the couch (or the floor, when I couldn't even make it to the couch).  I started saying "no" to people and tasks that wanted more from me than I had available to give.  Vacuuming and cleaning the bathrooms were just going to have to wait.  (They're still waiting, actually, even though I am more or less back to normal.  I really hate cleaning the bathroom!)

I still ran, because the alternative was going batshit crazy, but I kept my pace and mileage very, very low.  Most of my runs were two- or three-milers, and they frequently included walking breaks.  You might think that that was the hard part, running so few miles at such a slow pace, but it was so exhausting to run that I didn't want to do more.  More sounded hard, and maybe I should just take a nap instead.

And that's how I knew when I was starting to feel better:  simple daily tasks or the idea of trying to run four miles didn't sound overwhelming.

Becoming anemic wasn't like stepping off a cliff.  It snuck up on me that I had been travelling down into a canyon.  And recovering was sort of the same.  I definitely didn't feel worlds better all at once, but every few days I wouldn't feel like I was full of lead.  Sometimes the thought of making dinner didn't make me want to cry.  Once in awhile, I could breathe well enough to actually enjoy my run.  And then, with no extra attention on my part, those days started coming more often.  Once a week, or even twice.  I felt better often enough that I really noticed the days when I felt like crap.  I started to feel a little happier, a little lighter in my mood (but not in my pants - oh, lordy, that's a whole 'nother blog post right there about weight gain from lack of training).  I wanted to run a little farther or a little faster and it didn't seem like too much to ask.  And then one day I tried to remember the last time I took a nap and I didn't know when it was.  I ran a freakin' marathon and didn't take a nap afterwards!

So, it was time to call myself recovered.  Done with anemia.  Take the blood test to be sure, then write this final (knock on wood, God willing and the creek don't rise) blog post about how I used to be anemic.

If you only read one sentence in the whole post, let it be this one:  RECOVERY IS VITAL TO YOUR WELL-BEING!

Seriously.  I did this to myself.  I've given myself a fair amount of take-time-off-of-running injuries, but this one quite possibly sucked the most.  With tendinitis, you're back on the road in two or three weeks.  Stress fracture?  Six to eight weeks!  Being anemic, I felt like shit and derailed all of my training and racing plans for the better part of five months.  Don't do this.

And if you're already there?  Well, you're not alone.  Rest and be patient.  Be good to yourself, and someday (hopefully soon) this will be in your rearview mirror.

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